Senior Credentialing Coordinator

Job Summary:

• The Coordinator Credentialing Senior serves as the first line of defense in ensuring an organization has adequate and qualified medical staff. Under the supervision of leadership, this role is responsible for managing the credentialing department and ensuring compliance with regulatory and accrediting agencies.
• The position oversees all aspects of medical staff credentialing, including verification of education, training, certifications, licensure, and clinical practice credentials. The Coordinator Credentialing Senior serves as the primary liaison between administration and medical staff, providing guidance on credentialing standards, regulatory requirements, clinical privileges, and standards of care.
• This role demonstrates leadership by mentoring staff, managing strategic long-term projects, implementing process improvements, and maintaining all credentialing functions. Strong organizational, leadership, project management, and problem-solving skills are essential.

Key Responsibilities:

Credentialing & Compliance

• Manage all aspects of the credentialing process.
• Verify education, training, certifications, licensure, and clinical practice credentials.
• Ensure compliance with credentialing standards and accrediting bodies.
• Interpret regulatory standards and recommend process improvements.
• Maintain accurate credentialing databases and records.
• Track current licensure requirements for medical staff.
• Monitor documentation required for granting new or special clinical privileges.
• Ensure compliance with HIPAA regulations regarding Protected Health Information (PHI).

Leadership & Mentoring

• Serve as a role model and mentor for credentialing staff.
• Precept and train employees on credentialing responsibilities.
• Cross-train staff to ensure operational continuity.
• Advise medical staff leadership on credentialing priorities and regulatory updates.
• Assist leadership in understanding responsibilities related to credentialing.

Communication & Coordination

• Serve as liaison between administration and medical staff.
• Coordinate credentialing activities with regulatory agencies.
• Collaborate with internal departments to complete organizational goals.
• Communicate credentialing issues and updates to relevant stakeholders.

Meeting & Administrative Support

• Prepare meeting agendas and supporting documentation.
• Record accurate meeting minutes when required.
• Track attendance as required by medical staff bylaws.
• Assist with enforcement of bylaws, policies, procedures, rules, and regulations.
• Identify and communicate the need for policy revisions.

Project Management

• Lead at least one major strategic, long-term departmental project.
• Manage project timelines to ensure high-quality outcomes.
• Support strategic initiatives that improve credentialing operations.

Due Process Support

• Provide administrative support during Due Process proceedings.
• Attend hearings and appeals as needed.
• Record official proceedings and maintain documentation.

Minimum Requirements

Education:

• High School Diploma (Required)

Experience:

• 3 years of related experience (Preferred)

Certifications (Preferred):

• Certified Provider Credentialing Specialist (CPCS)
• Certified Medical Staff Coordinator (CMSC)

Required Skills:

• Medical staff credentialing
• Regulatory compliance
• Healthcare accreditation standards
• HIPAA compliance
• Leadership and mentoring
• Project management
• Organization and time management
• Problem-solving and decision-making
• Communication and interpersonal skills
• Policy and procedure implementation
• Database management
• Meeting coordination and documentation